Original article treatment options for keratocyst odontogenic tumour kcot. They present more commonly in the posterior mandible of young adults than the maxilla. Combined treatment of odontogenic keratocyst and mandibular defect with marsupialization, enucleation, iliac crest bone graft, and dental implants. Here we report a case of a recurrent buccal lesion in a 62yearold. Keratocysts possess outpouchings and microscopic daughter cysts from which recurrences may arise. Odontogenic keratocyst looks can be deceptive, causing. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. It has a locally aggressive behaviour and exhibits a high propensity to recur after treatment. Treatment of an odontogenic keratocyst although there are promising new techniques to treat an odontogenic keratocyst, the most common method of treatment is simply going into the jawbone and removing the odontogenic keratocyst.
Odontogenic keratocyst treatment with marsupialization and decompression. The wide surgical excision is often performed in patients who have multiple keratocysts present. Surgical treatment of keratocystic odontogenic tumour. The terms keratocyst or keratocystic odontogenic tumor were searched for and the. Although odontogenic keratocysts okcs are benign, they are often locally destructive and tend to recur after conservative surgical treatment. Odontogenic cysts and tumors michael underbrink, md anna pou, md february, 2002 introduction variety of cysts and tumors uniquely derived from tissues of. The okc is classified as a developmental epithelial cyst and comprises approximately 11% of all cysts of jaws. Surgical treatment algorithm for odontogenic keratocyst. A 14yearold caucasian girl presented for observation of bilateral. Optimal treatment of odontogenic keratocysts okc remains a matter of debate in the literature. Recommendations vary from enucleation, with or without adjunctive therapy such as application of carnoy solution, to marsupialization or decompression, to marginal or segmental resection. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour. Keratocystic odontogenic tumor in the maxillary sinus.
Calcifying odotogenic cyst is a benign odontogenic tumor of cystic type most likely to affect the anterior areas of the jaws. It is aggressive, grows rapidly and invades the surrounding tissues. Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Keratocystic odontogenic tumour of lesions treated in our clinic. Keratocystic odontogenic tumour kcot misdiagnosed as a. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Volume change pattern of decompression of mandibular odontogenic keratocyst volume change pattern of decompression of mandibular odontogenic keratocyst.
Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium. Conservative surgical removal and longterm followup is the treatment of choice by most clinicians. The cyst ruptured during excisional biopsy revealing contents typical of an odontogenic keratocyst okc. Topical 5fluorouracil is a novel targeted therapy for the. Okc received its new title as keratocystic odontogenic tumour kcot by the who 2005 in order to. Odontogenic keratocysts make up around 19% of jaw cysts. Pdf the odontogenic keratocyst okc is a recurrent cyst that has. Pdf orofacial cysts at komfo anokye teaching hospital, ghana. Pdf keratocystic odontogenic tumour with extraosseal. Odontogenic keratocyst okc has been the subject of great interest since philipsen introduced the term in 1956. It is characterized by its fast aggressive growth and high risk of recurrence. Depending on the size of the cyst, its location and the patients age, several treatment options are available.
Anthony pogrel, dds, md decompression of a cyst involves any technique that relieves the pressure within the cyst that causes it to grow. Okcs have been reclassified under odontogenic tumours in 2005 by the who and have since been termed as keratocystic odontogenic tumours kcots. Reclassification and treatment of odontogenic keratocysts. It is most common in people in their second to third decades but can be seen at almost any age. Odontogenic keratocyst in the mandible, surgical treatment. Keratocystic odontogenic tumors, keratocyst, odontogenic keratocyst, iodine tincture 1. The keratocystic odontogenic tumour kcot is a benign intraosseous odontogenic lesion relatively frequent in the oral cavity. For these health concerns, these are the most common treatment approaches. Keratocystic odontogenic tumors kots are benign lesions occurring in the maxilla or mandible with potential for serious morbidity.
Abstract the keratocystic odontogenic tumour kcot is a relatively common oral and maxillofacial lesion that derives from remnants of the dental lamina. Keratocystic odontogenic tumour canadian dental association. Introduction the keratocystic odontogenic tumor kcot is defined, according to the world health organization who as a benign tumor uni or multicystic, intraosseous tumor of odontogenicorigin, with a characteristic lining of pa. When the cyst is multilocular and located at the molar ramus area, it may be. It seems that odontogenic keratocysts come back for one of two reasons. Histology of odontogenic keratocyst and ameloblastoma histological examination of the odontogenic keratocysts showed palisading of the basal cell layer with nuclear polarization and a corrugated keratinized layer with alternating areas of orthokeratosis and parakeratosis. Approximately 50% of cases of nbccs are associated with allelic losses at. Treatment of mandibular odontogenic keratocyst by decompression with a customized removable device. Clinical consideration of a keratocystic odontogenic tumor in the differential diagnoses of the maxillary sinus lesions can affect the modality of treatment being used. Pdf a method for calculation of bone socket volume in. Pdf the keratocystic odontogenic tumour is classified as a developmental cyst derived. Odontogenic keratocyst okc is the cyst arising from the cell rests of dental lamina. Thus, it has been the subject of much research over the last 40 years. Radiographically, most okcs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
Report of a case a 55yearold man with a strong family history of basal cell nevus syndrome bcns had numerous basal cell carcinomas bccs and multiple associated odontogenic keratocysts. Conservative treatment of primary and nonsyndromic odontogenic. Surgical treatment of odontogenic keratocyst by enucleation ncbi. It is important to understand that these odontogenic keratocysts can be quite aggressive, destroying the local tissues. It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Investigations continue into the lesions pathologic classification, diagnosis and.
Nonetheless, odontogenic keratocyst presents a single form of developed odontogenic cyst and deserves special attention due to its pathological characteristics and specific clinical behavior. A case series juan gonzalez, dmd, omfs1 david malave, dmd, omfs1 dan holtzclaw, dds, ms2 1. Odontogenic keratocysts okcs are developmental cysts which occur typically in the jawbones. Ppt odontogenic cysts and tumors powerpoint presentation. The aim of the present study was to investigate its treatment and address. Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956. Clinically, the kot is manifested by an asymptomatic growth.
It was formerly known as odontogenic keratocyst okc. Presentation of a keratocystic odontogenic tumor with. Pdf the authors suggest a method for preoperative determination of bone cavity volume v in radicular cysts of the jaws by measurement of. A free powerpoint ppt presentation displayed as a flash slide show on id. Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. The present study reported the clinical outcomes of 35 patients with mandibular odontogenic keratocysts okcs following treatment by radical resection and immediate defect reconstruction.
The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. Multiple cystic spaces similar to those seen in botryoid odontogenic cysts. Odontogenic keratocyst symptoms, treatment, pictures. Pdf reclassification and treatment of odontogenic keratocysts. Locally, radicular periapical cysts were the most common odontogenic cyst 65. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. Previously known as odontogenic keratocysts okcs, kots were subsequently reclassified as a tumor by the world health. It most often affects the posterior mandible and most commonly presents in the third decade of life. Treatment options for keratocyst odontogenic tumour kcot. There is no uniform agreement as to the most appropriate method of treatment of odontogenic keratocysts. In various studies odontogenic keratocysts ranged from 2. In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst.
Surgical treatment of odontogenic keratocyst by enucleation. Management of keratocystic odontogenic tumour with. On radiographs, the calcifying odontogenic cyst appears as a unilocular radiolucency dark area. Keratocystic odontogenic tumour is relatively rare benign tumour. They must therefore be distinguished from other cysts of the jaw. The aggressive mode of treatment involves treating the okc as a neoplasm and includes en bloc resection and peripheral. Pdf conservative treatment protocol for keratocystic.
Cysts and tumors of the jaws treated by marsupialization. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. Reports of bone erosion, 1 orbital invasion, 2 skull base extension, 3 and temporal fossa violation 4 show the aggressive nature of this lesion. The most effective treatments are enucleation supplemented with carnoys solution, or marsupial. Identical to structures present in lateral periodontal cysts or botryoid odontogenic cysts or soft tissue odontogenic cyst, gingival cyst of adult multiple cyst compartments.
Case report a 28year old man was referred to the department of oral surgery complaining of painless swelling in the. Coelho1 1oral surgery department, school of dentistry, university of lisbon, lisbon, portugal 2improvement in teaching methods in conservative dentistry, school of dentistry, university of lisbon, lisbon, portugal key words. Odontogenic keratocyst marsupialization and decompression. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. Endoscopic removal of an odontogenic keratocyst in the. Reclassification and treatment of odontogenic keratocysts scielo. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. Subjects and methods the case files of all patients who had histological confirmation of the diagnosis of odontogenic keratocyst from 19801995, at both the cornwall regional hospital and. The odontogenic keratocyst okc is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. Growth of cysts is believed to occur by a combination of osmotic pressure and pressure resorption,1 coupled with release of pros. Variable amounts of keratin were seen in the cystic lumen.
The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of malassez or the remnants of the dental lamina. Risk factors for postoperative infection of odontogenic. Resolution of odontogenic keratocysts of the jaw in basal. A large extragnathic keratocystic odontogenic tumour. In onethird of cases, an impacted tooth is involved. As far we know this is the first case of the odontogenic keratocyst originating from the. This novel drug, useful for the treatment of bcc, also appears to be effective for treatment of odontogenic keratocysts. Odontogenic keratocyst okc is a locally aggressive odontogenic cyst with a high recurrence rate after treatment. Conservative treatment protocol for keratocystic odontogenic.831 678 1013 833 1554 57 1465 812 723 1481 1602 1255 248 1636 806 585 1430 1527 298 271 708 1460 719 488 1515 1394 309 634 1067 406 331 17 349 276 646 447 1251 437